JMIR Publications

ABSTRACT

Background:

Breast cancer patients during postoperative chemotherapy intervals commonly experience psychological distress and reduced resilience while recovering at home. Digital mindfulness interventions may provide accessible psychological support during this vulnerable period; however, evidence regarding tailored interventions for postoperative breast cancer patients during chemotherapy intervals remains limited.

Objective:

This study aimed to examine the effectiveness of a digital intervention on psychological resilience in postoperative breast cancer patients during chemotherapy intervals.

Methods:

A quasi-experimental study with repeated measures was conducted from October 2021 to June 2022. A total of 80 eligible participants were recruited from the Department of Breast Surgery at a tertiary hospital in Zhejiang Province, China, and 71 completed the study. The control group received routine discharge instructions and nursing follow-ups, whereas the intervention group additionally received an 8-week digital psychological resilience intervention. Outcomes were assessed at baseline (T0), 3 months postintervention (T1), and 6 months postintervention (T2). The measures included the Connor-Davidson Resilience Scale (CD-RISC), Hospital Anxiety and Depression Scale (HADS), Social Support Rating Scale (SSRS), Breast Cancer Survivor Self-Efficacy Scale (BCSSS), and Functional Assessment of Cancer Therapy-Breast (FACT-B). Independent-samples t tests, chi-square tests, and repeated-measures ANOVA were performed using SPSS 26.0.

Results:

No statistically significant baseline differences were observed between the two groups in the outcome measures. At T1, the intervention group had higher CD-RISC scores than the control group (67.58 ± 11.41 vs 62.09 ± 10.18; P=.036) and higher BCSSS scores (42.36 ± 3.59 vs 39.23 ± 4.90; P=.003). However, these between-group differences were no longer statistically significant at T2 (P>.05). Significant time effects and group × time interaction effects were observed for both psychological resilience and self-efficacy (P<.05). HADS scores were lower in the intervention group than in the control group at both T1 (11.78 ± 1.48 vs 15.86 ± 1.54; P<.001) and T2 (9.69 ± 1.51 vs 12.03 ± 1.42; P<.001), with significant time, group, and group × time interaction effects (P<.05). For SSRS and FACT-B scores, no statistically significant between-group differences were found at T1 or T2 (P>.05), although both scales showed significant time effects (P<.05).

Conclusions:

The digital psychological resilience intervention effectively alleviated anxiety and depression in postoperative breast cancer patients during chemotherapy intervals. It also significantly enhanced their psychological resilience and self-efficacy in the early postintervention phase. Although the improvements in psychological resilience and self-efficacy did not remain statistically superior to those of the control group at the 6-month endpoint, the intervention improved the recovery trajectory of the patients and provided significant short-term benefits during the early postintervention period. Future research should explore strategies to maintain these gains over the long term. Clinical Trial: Chinese Clinical Trial Registry ChiCTR2100047251.